Rene David Juan, D.D.M.

Primary specialty

DentistTaxonomy code 122300000X

License

001133 Issued in PR

Practice address

65 Calle Pedro Santos
Suite 3
Moca, PR 00676-4015

Phone

(787) 877-5865

Fax

(787) 877-5865

NPI assigned

Oct 6, 2005

Last updated

Jul 13, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1003804857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 CALLE PEDRO SANTOS",
            "address_2": "SUITE 3",
            "city": "MOCA",
            "state": "PR",
            "postal_code": "006764015",
            "telephone_number": "787-877-5865",
            "fax_number": "787-877-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 CALLE PEDRO SANTOS",
            "address_2": "SUITE 3",
            "city": "MOCA",
            "state": "PR",
            "postal_code": "006764015",
            "telephone_number": "787-877-5865",
            "fax_number": "787-877-5865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUAN",
        "first_name": "RENE",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PR",
            "license": "001133",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "0011826",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Moca, PR
• Providers in Moca, PR by specialty
• Dentist in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.